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Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study
BACKGROUND: Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Ad...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053081/ https://www.ncbi.nlm.nih.gov/pubmed/32122334 http://dx.doi.org/10.1186/s12873-020-00308-z |
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author | van der Mei, Willem F. Barbano, Anna C. Ratanatharathorn, Andrew Bryant, Richard A. Delahanty, Douglas L. deRoon-Cassini, Terri A. Lai, Betty S. Lowe, Sarah R. Matsuoka, Yutaka J. Olff, Miranda Qi, Wei Schnyder, Ulrich Seedat, Soraya Kessler, Ronald C. Koenen, Karestan C. Shalev, Arieh Y. |
author_facet | van der Mei, Willem F. Barbano, Anna C. Ratanatharathorn, Andrew Bryant, Richard A. Delahanty, Douglas L. deRoon-Cassini, Terri A. Lai, Betty S. Lowe, Sarah R. Matsuoka, Yutaka J. Olff, Miranda Qi, Wei Schnyder, Ulrich Seedat, Soraya Kessler, Ronald C. Koenen, Karestan C. Shalev, Arieh Y. |
author_sort | van der Mei, Willem F. |
collection | PubMed |
description | BACKGROUND: Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requires skilled professionals, and relies on symptoms that are not fully expressed upon acute care admission. Predicting chronic PTSD from peritraumatic responses, which are obtainable upon acute care admission, has yielded conflicting results, hence the rationale for a stepwise screening-and-prediction practice. This work explores the ability of peritraumatic responses to produce risk likelihood estimates of early CAPS-based PTSD symptoms indicative of chronic PTSD risk. It specifically evaluates the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) as a risk-likelihood estimator. METHODS: We used individual participant data (IPD) from five acute care studies that used both the PDEQ and the CAPS (n = 647). Logistic regression calculated the probability of having CAPS scores ≥ 40 between 30 and 60 days after trauma exposure across the range of initial PDEQ scores, and evaluated the added contribution of age, sex, trauma type, and prior trauma exposure. Brier scores, area under the receiver-operating characteristic curve (AUC), and the mean slope of the calibration line evaluated the accuracy and precision of the predicted probabilities. RESULTS: Twenty percent of the sample had CAPS ≥ 40. PDEQ severity significantly predicted having CAPS ≥ 40 symptoms (p < 0.001). Incremental PDEQ scores produced a reliable estimator of CAPS ≥ 40 likelihood. An individual risk estimation tool incorporating PDEQ and other significant risk indicators is provided. CONCLUSION: Peritraumatic reactions, measured here by the PDEQ, can reliably quantify the likelihood of acute PTSD symptoms predictive of chronic PTSD and requiring clinical attention. Using them as a screener in a stepwise chronic PTSD prediction strategy may reduce the burden of later CAPS-based assessments. Other peritraumatic metrics may perform similarly and their use requires similar validation. TRIAL REGISTRATION: Jerusalem Trauma Outreach and Prevention Study (J-TOPS): NCT00146900. |
format | Online Article Text |
id | pubmed-7053081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70530812020-03-10 Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study van der Mei, Willem F. Barbano, Anna C. Ratanatharathorn, Andrew Bryant, Richard A. Delahanty, Douglas L. deRoon-Cassini, Terri A. Lai, Betty S. Lowe, Sarah R. Matsuoka, Yutaka J. Olff, Miranda Qi, Wei Schnyder, Ulrich Seedat, Soraya Kessler, Ronald C. Koenen, Karestan C. Shalev, Arieh Y. BMC Emerg Med Research Article BACKGROUND: Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requires skilled professionals, and relies on symptoms that are not fully expressed upon acute care admission. Predicting chronic PTSD from peritraumatic responses, which are obtainable upon acute care admission, has yielded conflicting results, hence the rationale for a stepwise screening-and-prediction practice. This work explores the ability of peritraumatic responses to produce risk likelihood estimates of early CAPS-based PTSD symptoms indicative of chronic PTSD risk. It specifically evaluates the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) as a risk-likelihood estimator. METHODS: We used individual participant data (IPD) from five acute care studies that used both the PDEQ and the CAPS (n = 647). Logistic regression calculated the probability of having CAPS scores ≥ 40 between 30 and 60 days after trauma exposure across the range of initial PDEQ scores, and evaluated the added contribution of age, sex, trauma type, and prior trauma exposure. Brier scores, area under the receiver-operating characteristic curve (AUC), and the mean slope of the calibration line evaluated the accuracy and precision of the predicted probabilities. RESULTS: Twenty percent of the sample had CAPS ≥ 40. PDEQ severity significantly predicted having CAPS ≥ 40 symptoms (p < 0.001). Incremental PDEQ scores produced a reliable estimator of CAPS ≥ 40 likelihood. An individual risk estimation tool incorporating PDEQ and other significant risk indicators is provided. CONCLUSION: Peritraumatic reactions, measured here by the PDEQ, can reliably quantify the likelihood of acute PTSD symptoms predictive of chronic PTSD and requiring clinical attention. Using them as a screener in a stepwise chronic PTSD prediction strategy may reduce the burden of later CAPS-based assessments. Other peritraumatic metrics may perform similarly and their use requires similar validation. TRIAL REGISTRATION: Jerusalem Trauma Outreach and Prevention Study (J-TOPS): NCT00146900. BioMed Central 2020-03-02 /pmc/articles/PMC7053081/ /pubmed/32122334 http://dx.doi.org/10.1186/s12873-020-00308-z Text en © The Author(s) 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article van der Mei, Willem F. Barbano, Anna C. Ratanatharathorn, Andrew Bryant, Richard A. Delahanty, Douglas L. deRoon-Cassini, Terri A. Lai, Betty S. Lowe, Sarah R. Matsuoka, Yutaka J. Olff, Miranda Qi, Wei Schnyder, Ulrich Seedat, Soraya Kessler, Ronald C. Koenen, Karestan C. Shalev, Arieh Y. Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title | Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title_full | Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title_fullStr | Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title_full_unstemmed | Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title_short | Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study |
title_sort | evaluating a screener to quantify ptsd risk using emergency care information: a proof of concept study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053081/ https://www.ncbi.nlm.nih.gov/pubmed/32122334 http://dx.doi.org/10.1186/s12873-020-00308-z |
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